The present invention relates to a medical forceps for removal of tissue from the human or animal body, having two jaw parts at the end nearest the patient which can be moved relative to one another via grip elements at the end remote from the patient, the jaw parts having blades which coact in cutting fashion as the jaw parts are closed.
The invention further relates to a medical forceps for removal of tissue from the human or animal body, having two jaw parts at the end nearest the patient which can be moved relative to one another via grip elements at the end remote from the patient, the jaw parts butting against one another in blunt fashion upon closing in order to grasp tissue.
Forceps of this kind of the first aforementioned type for detaching tissue, and forceps of this kind as cited secondly for grasping tissue, are commonly known.
In a surgical operation on the human or animal body, forceps for detaching tissue are used to detach or cut away tissue, for example organ or bone tissue. For this purpose, the forceps have at their end nearest the patient two jaw parts which have blades, i.e. sharpened regions with sharp cutting edges, which coact in order to detach the tissue.
There is known, for example, from the German brochure "Karl Storz Endoskope, Endoskopische Chirurgie" [Karl Storz endoscopes, endoscopic surgery], section 5, page SCT 5/4A (FRANGENHEIM forceps), a forceps referred to as "cut-through," the jaw parts of which have cutting edges in the longitudinal direction of the forceps or of the jaw parts, as well as front cutting edges running transverse to the longitudinal direction. "Cut-through" means that during cutting, a movable jaw part is moved through an immovable one, the blades moving past one another and detaching a piece of tissue grasped between them.
Also known, however, are forceps for the detachment of tissue which have only blades running in the longitudinal direction, which thus cut into the tissue in the manner of a scissors.
Also known are so-called "spoon forceps," whose two jaw parts each have a blade which butts against the other as the jaw parts are closed but do not move past one another, thus coacting in cutting fashion.
All the forceps of the afore-mentioned kinds can be used only to detach tissue. It is not possible with these forceps to grasp the detached tissue and remove it from the human body.
The forceps provided for removal of tissue samples are so-called grasping forceps, i.e. forceps of the type cited secondly above, the jaw parts of which are configured not as cutting tools but as grasping tools, which thus have surfaces that butt against one another in blunt fashion, and between which the detached tissue can be grasped without being cut in two.
In surgical operations in which pieces of tissue are to be removed, the surgeon is therefore compelled to use two forceps to detach and to remove the tissue, namely a cutting forceps and a grasping forceps. This has the disadvantage, however, that the surgeon must become familiar with the operation of two different forceps in order to acquire the operating confidence necessary in order to use them. Since, in addition, the tissue to be removed often cannot be detached with only a single cutting operation, the surgeon must switch forceps several times so as to remove from the body with the grasping forceps a piece of tissue initially detached with the cutting forceps. The result is that during a surgical procedure, the surgeon must repeatedly put down one forceps and pick up the respective other forceps.
A further disadvantage is the elevated cost of such known forceps, resulting from the fact that two complete forceps, one for detaching and one for grasping, must be made available with their shafts, actuation elements, and grip elements, although the cutting forceps and grasping forceps need to differ in functional terms only with regard to their jaw parts.
Since surgeons regard the switching of forceps as disadvantageous, they occasionally attempt to grasp the piece of tissue detached by the cutting forceps using the jaw parts of the cutting forceps; this entails the risk, however, that the piece of tissue being grasped will be separated into two parts as the forceps is being withdrawn, and the parts will remain in the body.
U.S. Pat. No. 4,711,240 furthermore discloses a surgical instrument with which tissue can be resected from soft, spongy organs, for example from the kidneys or the liver, without thereby damaging blood vessels present in those organs. For this purpose, the known instrument has at the end nearest the patient detachment tools configured in comb fashion which are closed toward one another, the blunt comb teeth engaging into one another and resecting the tissue from both sides of the organ. The comb-like detachment tools do not, however, coact in cutting fashion. Instead, when the detachment tools are closed, the tissue of the organ is crushed between the comb teeth and can then be flushed out. With this instrument it is not possible to grasp the resected tissue. An attachment having a smooth surface can be sticked on one of the two detachment tools and can then be used if tissue is to be resected from the organ from one side only, for example to remove kidney stones.
Also known, from EP-A-0 598 607, is a surgical forceps which is not cutting, but rather is used for atraumatic grasping of organs or blood vessels in order to move them aside so as to expose the operative area concealed behind them. For this purpose, the jaw parts are equipped with atraumatic, releasably mountable cushions, which do not traumatize or even damage the grasped organs or vessels when the jaw parts are closed. These known forceps cannot, however, be used as a cutting tool.
Even with the instruments cited above, there still exists the disadvantage that they have only one function, i.e. either only detaching tissue or only grasping tissue.